Theranova is a novel medium cut-off dialyzer and has better performance for removal of middle molecules compared to conventional hemodialysis. The study investigates the effect of Theranova dialzyer on preserving residual renal function in the incident hemodialysis pateitns compared to high-flux dialzyer. The primary endpoint is change of glomerular filtration rate, calculated using creatinine and urea clearance. The secondary endpoints are serial changes of glomerular filtration rate and daily urine volume, changes of serum middle molecule concentrations, hospitalization, mortality, and patient reported outcomes.

Inclusion Criteria:

• Incident end-stage renal disease ESRD patient receiving hemodialysis for less than 1 month
• 18 years old and older
• Creatinine clearance of more than 2 ml/min
• Agreement to participate in the clinical study
• Vascular access by arteriovenous fistula/graft

Exclusion Criteria:

• Plan for kidney transplantation within 6 months
• Severe volume overloading state
• Dialysis through permanent catheter
• Any hematologic malignancy or monoclonal gammopathy
• Any malignancy
• Active infectious disease
• HIV infection
• Patient enrolled to another study within 3 month from starting the present study